title: Can long-term bisphosphonate use causes low-energy fractures? A case report.
abstract: Bisphosphonates are inorganic pyrophosphate analog which accumulate on the bone surface, cause osteoclast apoptosis, and inhibit bone resorption. The nitrogen-containing bisphosphonates continue to be the drug of choice for the treatment of osteoporosis in both men and women. Although histomorphometric studies including bone biopsies have not shown any evidence of microcracks, recent studies have revealed that potent bisphosphonates are responsible for the oversuppression of bone turnover leading to microdamages, reduced bone strength, and increased fracture risk. There are individual cases reporting atypical femoral fractures and severely suppressed bone turnover along with long-term (≥ 5 years) use of biphosphonates. In this study, we report on a 74-year-old woman with a history of continuous alendronate use for nearly 16 years who presented to the emergency department with right proximal humerus and left femur fracture.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Haydarpaşa Training Hospital, Gülhane Military Medical Academy, Istanbul, Turkey, dandinoglu@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Dandinoğlu
authors.forename: S
authors.initials: S
authors.lastname: Akarsu
authors.forename: M
authors.initials: M
authors.lastname: Karadeniz
authors.forename: L
authors.initials: L
authors.lastname: Tekin
authors.forename: S
authors.initials: S
authors.lastname: Arıbal
authors.forename: M Z
authors.initials: MZ
authors.lastname: Kıralp
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced / Q000000981:diagnostic imaging; D005598:Fractures, Spontaneous / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D006810:Humeral Fractures / Q000139:chemically induced / Q000000981:diagnostic imaging; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D011859:Radiography
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates